scholarly journals 43 Echocardiographical analysis of right ventricular function after transcatheter edge-to-edge repair of tricuspid regurgitation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Ozturk ◽  
J Vogelhuber ◽  
D Reckers ◽  
M U Becher ◽  
G Nickenig ◽  
...  
Keyword(s):  
Heart Failure ◽  
Tricuspid Regurgitation ◽  
Systolic Function ◽  
Right Heart Failure ◽  
Tissue Doppler ◽  
High Grade ◽  
Myocardial Performance ◽  
Right Heart ◽  
Color Tissue Doppler ◽  
Rv Function

Abstract Tricuspid regurgitation (TR) is a frequent valvular heart disease associated with increased mortality and morbidity. RV function is mostly assessed using tricuspid annulus plane systolic excursion (TAPSE), which shows merely systolic RV function and can be influenced by many other pathologies and image quality. Furthermore, the impact of dedicated percutaneous clip treatment of TR on RV global function and clinical outcomes are scarce. We aim to perform detailed echocardiographical global RV function analysis inclusively speckle tracking of RV before and after transcatheter edge-to-edge repair of TR (TTVR). We evaluated 50 patients, who underwent between January 2017 to March 2018 TTVR in our center. Apical four chamber images were used to perform strain analysis of RV. The systolic velocity of free RV wall (S´ Vmax) was measured through PW doppler on lateral TV annulus in color tissue Doppler. RV myocardial performance index is a parameter for systolic as well as diastolic ventricle function and can be calculated using ratio between TV closure to opening time and RV ejection time (RVCOT-RVET/RVET), which can be assessed from PW Doppler of lateral TV annulus in color tissue Doppler. We retrospectively included 40 patients (73 ± 5.6 years, 32% female) with symptomatic (65% ascites, 95% edema, 100% NYHA > II) high grade functional TR at surgical high risk (EuroSCORE II: 7.6%). 95% of all interventions were successfully performed (TR reduction at least I grade). Our collective shows normal baseline left ventricle (LV) systolic function (Ejection fraction: 60.8 ± 4.6%) with diastolic LV dysfunction and increased LV end systolic pressure (E/E´ ratio: 17.7 ± 6.5). Baseline RV analysis presented impaired RV systolic function (TAPSE: 1.2 ± 3.2 cm, RV-FAC: 25.6 ± 9.8%, S´ Vmax: 5.6 ± 1.2cm/s) with decreased RV global longitudinal strain (RV-GLS: -8.9 ± 4.3). RV myocardial performance index (RV-MPI) was 0.51 ± 0.4 as a parameter for poor global RV function. Baseline echocardiography showed dilation of both atria (Left atrium: 80.5 ± 14.5ml, right atrium: 26.7 ± 7.8cm2) with pronounced right ventricle congestion (dilated vena cava inferior: 25.5 ± 3.4mm without breath modulation, paradoxical intraventricular septum motion, dilated RV: 57.7 ± 14.5cm2). All TR were high grade (PISA: 0.78 ± 0.3cm, VC width: 0.8 ± 0.2cm, EROA: 0.43 ± 0.1cm2, regurgitant volume: 67.1 ± 10.4ml) and functional with mostly anteroseptal (85%) coaptation defect (coaptation defect diameter: .5.7 ± 3.2mm). The right heart failure symptoms significantly improved three months after the procedure. Patients with severe right heart failure (TAPSE < 1cm) showed more often rehospitalization and limited improvements in symptoms (p = 0.02). RV function should be more comprehensively evaluated before interventional TR therapy. The patients with already preprocedural severe right heart failure should be more critically discussed. RV-GLS and RV-MPI are strongest independent parameter of clinical outcome after TTVR.

scholarly journals Prognostic Implications of Staging Right Heart Failure in Patients With Significant Secondary Tricuspid Regurgitation

2020 ◽  
Vol 8 (8) ◽  
pp. 627-636 ◽  
Author(s):  
Marlieke F. Dietz ◽  
Edgard A. Prihadi ◽  
Pieter van der Bijl ◽  
Nina Ajmone Marsan ◽  
Victoria Delgado ◽  
...  
Keyword(s):  
Heart Failure ◽  
Tricuspid Regurgitation ◽  
Right Heart Failure ◽  
Right Heart ◽  
Prognostic Implications

scholarly journals Tricuspid Regurgitation and Right Heart Failure

2020 ◽  
Vol 8 (8) ◽  
pp. 637-639 ◽  
Author(s):  
Wayne Batchelor ◽  
Abbas Emaminia
Keyword(s):  
Heart Failure ◽  
Tricuspid Regurgitation ◽  
Right Heart Failure ◽  
Right Heart

scholarly journals Traumatic avulsion of the tricuspid valve after gas bottle explosion

2016 ◽  
Vol 3 (2) ◽  
pp. K21-K24
Author(s):  
Francesca Tedoldi ◽  
Maximilian Krisper ◽  
Clemens Köhncke ◽  
Burkert Pieske
Keyword(s):  
Heart Failure ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Right Heart Failure ◽  
Severe Illness ◽  
List Type ◽  
Right Heart ◽  
The Right

SummaryWe present a very rare example of chronic right heart failure caused by torrent tricuspid regurgitation. Massive right heart dilatation and severe tricuspid regurgitation due to avulsion of the tricuspid valve apparatus occurred as a result of a blunt chest trauma following the explosion of a gas bottle 20 years before admission, when the patient was a young man in Vietnam. After this incident, the patient went through a phase of severe illness, which can retrospectively be identified as an acute right heart decompensation with malaise, ankle edema, and dyspnea. Blunt chest trauma caused by explosives leading to valvular dysfunction has not been reported in the literature so far. It is remarkable that the patient not only survived this trauma, but had been managing his chronic heart failure well without medication for over 20 years.Learning pointsThorough clinical and physical examination remains the key to identifying patients with relevant valvulopathies.With good acoustic windows, TTE is superior to TEE in visualizing the right heart.Traumatic avulsion of valve apparatus is a rare but potentially life-threatening complication of blunt chest trauma and must be actively sought for. Transthoracic echocardiography remains the method of choice in these patients.

scholarly journals 319 Right heart chambers geometry and function in patients with the atrial and the ventricular phenotypes of functional tricuspid regurgitation

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Diana Ruxandra Florescu ◽  
Denisa Muraru ◽  
Cristina Florescu ◽  
Mara Gavazzoni ◽  
Valentina Volpato ◽  
...  
Keyword(s):  
Tricuspid Regurgitation ◽  
Systolic Function ◽  
Three Dimensional ◽  
Right Heart ◽  
Maximal Volume ◽  
Functional Tricuspid Regurgitation ◽  
Permanent Atrial Fibrillation ◽  
Z Scores ◽  
And Function ◽  
Rv Function

Abstract Aims Atrial functional tricuspid regurgitation (A-FTR) is a recently defined phenotype of FTR associated with persistent/permanent atrial fibrillation. Differently from the classical ventricular form of FTR (V-FTR), patients with A-FTR might present with severely dilated right atrium (RA) and tricuspid annulus (TA), and with preserved right ventricular (RV) size and systolic function. However, the geometry and function of the RV, RA, and TA in patients with A-FTR and V-FTR remain to be systematically evaluated. Accordingly, we sought to: (i) study the geometry and function of the RV, RA, and TA in A-FTR by two- and three-dimensional transthoracic echocardiography and (ii) compare them with those found in V-FTR. Methods and results We prospectively analysed 113 (44 men, age 68 ± 18 years) FTR patients (A-FTR = 55 and V-FTR = 58) that were compared to two groups of age- and sex-matched controls to develop the respective Z-scores. Severity of FTR was similar in A-FTR and V-FTR patients. Z-scores of RV size were significantly larger, and those of RV function were significantly lower in V-FTR than in A-FTR (P < 0.001 for all). The RA was significantly enlarged in both A-FTR and V-FTR compared to controls (P < 0.001, Z-scores > 2), with similar RA maximal volume (RAVmax) between A-FTR and V-FTR (P = 0.2). Whereas, the RA minimal volumes (RAVmin) were significantly larger in A-FTR than in V-FTR (P = 0.001). Conclusions Despite similar degrees of FTR, and RAVmax size, A-FTR patients show a larger RAVmin, and smaller TA areas than V-FTR patients. Conversely, V-FTR patients show dilated, more elliptic, and dysfunctional RV than A-FTR patients.

PROGNOSTIC IMPLICATIONS OF STAGING RIGHT HEART FAILURE IN SIGNIFICANT FUNCTIONAL TRICUSPID REGURGITATION

2019 ◽  
Vol 73 (9) ◽  
pp. 1993
Author(s):  
Marlieke Dietz ◽  
Edgard Prihadi ◽  
Pieter van der Bijl ◽  
Nina Ajmone Marsan ◽  
Victoria Delgado ◽  
...  
Keyword(s):  
Heart Failure ◽  
Tricuspid Regurgitation ◽  
Right Heart Failure ◽  
Right Heart ◽  
Functional Tricuspid Regurgitation ◽  
Prognostic Implications

scholarly journals Tachycardia-Induced Right Heart Failure and Severe Tricuspid Regurgitation That Improved with Medication

2015 ◽  
Vol 51 (3) ◽  
pp. 135
Author(s):  
Young Ae Yang ◽  
Dong Heon Yang ◽  
Hong Nyun Kim ◽  
Sang Hoon Kwon ◽  
Se Young Jang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Tricuspid Regurgitation ◽  
Right Heart Failure ◽  
Right Heart ◽  
Severe Tricuspid Regurgitation

Normal myocardial function in severe right ventricular volume overload hypertrophy

2001 ◽  
Vol 280 (1) ◽  
pp. H11-H16 ◽  
Author(s):  
Yuji Ishibashi ◽  
Judith C. Rembert ◽  
Blase A. Carabello ◽  
Shintaro Nemoto ◽  
Masayoshi Hamawaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Tricuspid Regurgitation ◽  
Contractile Function ◽  
Right Heart Failure ◽  
Ventricular Volume ◽  
Left Ventricular ◽  
Right Ventricular Volume ◽  
Right Heart ◽  
Severe Tricuspid Regurgitation

Severe left ventricular volume overloading causes myocardial and cellular contractile dysfunction. Whether this is also true for severe right ventricular volume overloading was unknown. We therefore created severe tricuspid regurgitation percutaneously in seven dogs and then observed them for 3.5–4.0 yr. All five surviving operated dogs had severe tricuspid regurgitation and right heart failure, including massive ascites, but they did not have left heart failure. Right ventricular cardiocytes were isolated from these and from normal dogs, and sarcomere mechanics were assessed via laser diffraction. Right ventricular cardiocytes from the tricuspid regurgitation dogs were 20% longer than control cells, but neither the extent (0.171 ± 0.005 μm) nor the velocity (2.92 ± 0.12 μm/s) of sarcomere shortening differed from controls (0.179 ± 0.005 μm and 3.09 ± 0.11 μm/s, respectively). Thus, despite massive tricuspid regurgitation causing overt right heart failure, intrinsic right ventricular contractile function was normal. This finding for the severely volume-overloaded right ventricle stands in distinct contrast to our finding for the left ventricle severely volume overloaded by mitral regurgitation, wherein intrinsic contractile function is depressed.

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